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Clin J Am Soc Nephrol · Mar 2008
ReviewAdvances in critical care for the nephrologist: hemodynamic monitoring and volume management.
- Danielle Davison and Christopher Junker.
- Department of Anesthesiology and Critical Care Medicine, George Washington University, 900 23rd Street NW, Washington, DC 20037, USA. ddavison@mfa.gwu.edu
- Clin J Am Soc Nephrol. 2008 Mar 1; 3 (2): 554-61.
AbstractThe monitoring of physiologic variables is an integral part of the diagnosis and management of the critically ill patient. Restoration of tissue perfusion and oxygen delivery is the ultimate goal for any state of circulatory collapse. Insight into a patient's intravascular volume status and cardiac performance, particularly in the early stages of shock, can help guide management and potentially change outcome. In the past 30 years, various bedside monitoring techniques and indices have been developed in an effort to determine and optimize a patient's cardiac performance. This article reviews the physiologic parameters that best predict intravascular volume status and volume responsiveness. We examine the controversies surrounding the pulmonary arterial catheter and describe the less invasive methods of measuring cardiac performance.
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